NURSING RESPONSIBILITIES TOWARDS A BABY-FRIENDLY HOSPITAL INITIATIVE IN A NEONATAL INTENSIVE CARE UNIT: THE EXPERIENCE OF BAMBINO GESù CHILDREN’S HOSPITAL

Objective Breastfeeding initiation and duration encounters obstacles for hospitalised newborns in neonatal intensive care units (NICU). Although referred to healthy full term infants, the baby-friendly hospital initiative appears to contribute to increasing breastfeeding practice among infants in NICU. In this contest the nurse has many responsibilities in order to help mother/infant couples breastfeed. Aim To describe the experience of the nursing staff at the NICU of Bambino Gesu Childrens’ Hospital in supporting the mothers to initiate and maintain breastfeeding over time. Materials and Methods A specific education about breastfeeding for high-risk infants was planned. The nurses were involved in defining the most important procedures regarding breastfeeding promotion and support in the NICU setting and nursing responsibilities. Results Three courses have been performed in 2007/8, 40% of the team has been trained. Five procedures were performed: family information about milk collection; management of the milk collection room and of own mother’s milk (OMM); management of meal requests in order to prevent OMM waste; kangaroo mother’s care; oral stimulation and feeding in order to protect breastfeeding. The main nursing responsibilities are: family information and education, individual counselling and practice support for the mothers in the different stages of breastfeeding, management of room and materials for milk collection, documentation regarding feeding. Conclusions We suggest that an adapted version of the “10 steps” to the NICU setting, relating the characteristics of such high-risk infants and their families could guide new changes. Meantime nurses have many responsibilities that can and must be applied.